Discipline: Social Science, Health, Medicine
More than 100 years ago, in March 24 1882, Koch read his paper entitled "Ueber Tuberculose" at the monthly meeting of the Physiological Society of Berlin. He presented his discovery of the "germ" now known as Mycobacterium tuberculosis to be the causative agent of a then mysterious disease. Before Koch's discovery of the "germ", tuberculosis was referred to as "consumption" and considered a fashionable disease afflicting the over-stressed wealthier members of the society. Since it was known that the disease is caused by an organism, it has developed a stigma and has been associated with the unhygienic practices of the poorer members of society. Since that time, tuberculosis persisted as a major problem in the underdeveloped and developing countries (Enarson, 1992). Recently, it has re-emerged in the developed countries with the occurrence of the AIDS epidemic (Slutkin, 1992). Despite the availability of highly effective, laboratory-tested treatment regimens, cure rates remain low (WHO, 1993). The most common cause of treatment failure is that either the patients delay treatment or they do not take the medications as prescribed (Menzies et. al., 1992). More than 100 years since Koch read his paper, the first World Congress on tuberculosis was held in Bethesda, Maryland attended by public health leaders, scientists, physicians, and health care workers from more than 37 nations around the globe. The message set forth during the meeting was that "we must renew our faith in the legacy of Koch and rededicate our efforts to the conquest of tuberculosis" (World Congress, 1992). Emphasis was placed on the role of behavioral research and intervention in addressing the problem of treatment failures secondary to non-compliance (Sumartojo, 1993).
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